LEARNING OBJECTIVES • disclose the main problems which lead to misdiagnosis and mistreatment of patients suffering from HIV-associated salivary gland diseases (HIV-SGD), especially the cystic ones; • distinguish between different entities of HIV-associated cystic salivary gland diseases; • distinguish between other non-related HIV pathologies which can affect salivary glands and therefore can mimic HIV-SGDs.

INTRODUCTION salivary gland swelling is the most common salivary gland presentation in HIV-infected patients, which can be attributed to acute sialadenitis or with HIV-associated salivary gland disease (HIV-SGD)1; HIV-SGD is empirically considered to be an AIDS-defining condition; most common HIV-SGDs are BLEC (Benign Lymphoepithelial Cysts), BLEL (benign lymphoepithelial lesions), Sjogren’s syndrome (both primary SS associated with HIV or SS-like illness), DILS (Diffuse infiltrative lymphocytosis syndrome), viral sialadenitis, sialadenosis, etc. the majority of HIV-SGDs are located in the parotid gland because it is the only salivary...

-after a close review of the specialty literature, some of the issues found need to be mentioned: the nomenclature: in the past, regardless of their nature and histopathological mechanism, all HIV related salivary gland lesions containing cysts were considered altogether as being ARPC (AIDS-related parotid cysts)5. This term can cause confusion because it doesn’t specify which type of HIV-SGD (BLEC, BLEL or another salivary lesion which later developed cysts) refers to, and by considering two or more pathologies as being the same one it can...

- if a lymphoepithelial lesion appears at a patient with unknown HIV status, it should be tested right away; - it is important to differentiate between different types of lesions compounded in HIV-SGD because each one has a different management approach; - it is essential to differentiate between the two entities of ARPC (BLEC and BLEL) because each one has a different long-term implication regarding their malignant progression; - the cosmetic aspect cannot be neglected so the appropriate diagnostic and management should be implemented quickly.

. Koch BL, Hamilton BE, Hudgins PA, Harnsberger HR. Diagnostic Imaging: Head and Neck. Elsevier Health Sciences; 2016. 1348 p. 2. Ebrahim S, Singh B, Ramklass SS. HIV-associated salivary gland enlargement: a clinical review. SADJ. 2014 Oct;69(9):400–3. 3. Schiødt M, Dodd CL, Greenspan D, Daniels TE, Chernoff D, Hollander H, et al. Natural history of HIV-associated salivary gland disease. Oral Surg Oral Med Oral Pathol. 1992 Sep;74(3):326–31. 4. Sekikawa Y, Hongo I. HIV-associated benign lymphoepithelial cysts of the parotid glands confirmed by HIV-1 p24 antigen...